Diagnosis and treatment of Herlyn-Werner-Wunderlich syndrome: a case report

Introduction
Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital anomaly characterized by uterus didelphys with blind hemivagina and ipsilateral renal agenesis. It is one of the rare anomalies of the genitourinary system and is usually identified in the first few years after menarche.

Case report
An 18-year-old patient presented with painful menses for 1 year and was suspected for vaginal haematoma. Symptoms appeared 5 years after menarche.

Discussion
Magnetic resonance imaging of the pelvis revealed a congenital anomaly of the genital tract. Two steps of surgical management were performed. First, a hysteroscopic incision of the vaginal septa and evacuation of vaginal haematoma were performed. Subsequently, the vaginal septum was partially excised during laparohysteroscopy.

Conclusions
Ipsilateral renal agenesis was confirmed by ultrasound during hospitalization, and the diagnoses of obstructed hemivagina and ipsilateral renal anomaly syndrome were established. The aim of this study was to present the diagnostic and therapeutic approaches in HWW syndrome, and to draw attention to the challenges in its diagnosis, which can coexist with multiple complications.